Ahead of the upcoming election, Labor has promised a rigorous review of the National Disability Insurance Scheme (NDIS), focused on spending and administration, should it win office.
But workforce shortages present a danger to participants now. To ensure the stated ambitions of a market-based system in which NDIS participants can choose their own supports, Labor’s proposed review must focus on these pressing workforce issues.
Some NDIS participants aren’t having their most basic care needs met, such as assistance to get out of bed each day, because of a shortage of disability workers. Others cannot access assistive technology or other allied health assessments to achieve their goals for social or work participation.
Workforce solutions must focus on attracting a greater number of both international and local workers to the disability sector, while addressing the wage growth and career pathways currently lacking.
Early warnings ignored
Disability has historically been an employment sector that has been challenged by poor perceptions.
Low pay rates, a lack of career structure, supervision and mentoring, and a casualised workforce have limited both supply and growth.
Five years ago, the Productivity Commission warned that the disability workforce was growing too slowly to meet future demands of NDIS participants and their families. Since then, some NDIS participants have struggled to secure support workers, and have had difficulty accessing allied health workers such as physiotherapists, occupational therapists and speech pathologists.
Then came COVID
No-one could have foreseen the impact a pandemic would have on labour supply across all industries in Australia. With COVID cases surging, many workers have had to isolate.
This has been compounded by the international workforce supply to Australia having been completely shut off by border restrictions.
These multiple issues are now added to what was already causing both direct support and allied health workforce shortages, with the aged care and health sectors also competing for staff.
Policy responses so far inadequate
The Coalition government’s five-year NDIS national workforce plan, released last year, focuses on building capability of existing employment markets.
But it doesn’t address the need to increase the supply of disability and allied health staffing numbers, or include new or innovative ways to grow a quality workforce.
This means people with disability and service providers will continue to compete with other sectors trying to attract the same employees.
Without coordinated, supply-side government investment, the workforce growth issues will continue.
Add to this the fact there is currently no actual data on the number of workers in the NDIS.
Due to this data gap, to forecast workforce supply, the government uses modelling estimates from analysis of participant spending, using assumptions on the share of NDIS payments paid as labour costs.
But relying on actual spend is not accurate, as it does not base forecasting on the real demand, or factor in under-spending caused by lack of workforce supply.
Here are three things we can do now to attract a disability workforce and ensure appropriate support for people living with disability.
1. Increase strategic and skilled migration
We need a more targeted skilled migration program that includes a broader range of skilled visa categories, especially for the disability workforce skill shortages and rural and regional market supply gaps.
Both English-speaking and culturally and linguistically diverse groups will be important to attract into a growing and diverse disability workforce, for both direct support workers and allied health workers.
Government should increase migrant intakes for these skill categories.
2. Invest in new approaches to NDIS workforce development
The National Disability Insurance Agency (which runs the NDIS) has been investing in some small-scale pilot projects in areas with staff shortages. However, to date these projects have not been designed for replication, or scaled up to other areas.
More broadly, the Australian government has invested more than A$64 million in an NDIS Jobs and Market Fund – and previous to that an Innovative Workforce Fund – to support the growth of disability workers.
One example of this was the scaling up of mixed telehealth and face-to-face allied health student placements with NDIS participants. It aimed to attract students to work in the disability sector while studying, as well as preparing them for practice in the field.
The project also embedded disability lived experience within the education students received, employing NDIS participants to deliver education content. However, this program can’t be scaled up without supply-side investment.
A low-cost initiative for government would be to invest in NDIS-focused educator roles within universities. By investing in supervision programs, both face-to-face and telehealth services in allied health could be quickly expanded nationally.
This could not only ensure more disability workers, but provide employment for supervisors with disabilities. It would give students experience in the disability sector, give them paid work while they study, and they would graduate ready for NDIS practice.
3. Improve conditions for workers
Moving into the disability workforce needs to be a career pathway, with secure employment benefits and conditions that are competitive against other labour markets. This requires pay that recognises the value of education, training and experience, as well as access to a supportive workplace.
Equipping people with disability to manage and train their own workforce, while offering a safe employment environment, is also important to improve both NDIS participant experiences and worker retention.
Little progress has been made in addressing the disability workforce demand that exists, and competition from the health sector and an ageing population will only grow.
As Australians head to the polls, the incoming government is going to need strategies to ensure the growing disability workforce demand is met.